Conceptual and pathway models guiding research on identifying active treatment components of AAIs on stress-related outcomes

Patricia Pendry Author

04/26/2022 Added

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This is a recording of Dr. Patricia Pendry's presentation for the Nebraska Symposium on Motivation given on April 22, 2022.

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[00:00:00.600]Welcome back everyone our next speaker is Dr Patricia pendry who comes to us from the Department of human development at Washington State University i'm very excited to announce that Dr pendry has recently been promoted to full Professor.
[00:00:19.650]Jeffrey Stevens: So i'd like to congratulate you on this well deserved achievement in addition to her position in human development, Professor Professor pendry.
[00:00:30.120]Jeffrey Stevens: Is a graduate faculty Member in the prevention science program at Washington state.
[00:00:35.190]Jeffrey Stevens: For educational background includes a bachelor's in psychology and a PhD in child development and social policy from northwestern university.
[00:00:43.350]Jeffrey Stevens: Professor pendry applies a bio bio behavioral perspective to her research conducting randomized control trials in real life settings to determine the effects of animal assisted interventions on individuals.
[00:00:54.870]Jeffrey Stevens: physiological and effective components of mental health and academic success.
[00:00:59.610]Jeffrey Stevens: For work examines the active components and mechanisms that facilitate treatment effects, including the quality of dynamic and tragic.
[00:01:06.690]Jeffrey Stevens: behavior of animals, their handlers and animal assistant intervention clients are working at the whole with all of the individuals involved.
[00:01:14.400]Jeffrey Stevens: Professor pendry is currently the president of the international society for anthropology or I says, and as a quick plug that the conference is currently.
[00:01:25.830]Accepting abstracts and registration, so if you're interested in presenting work in that, please do so by Monday the abstract submission date is Monday so there's still time to get in for abstracts and plenty of time for registration for that for that conference of the summer.
[00:01:41.100]Jeffrey Stevens: locker pendry is a lifelong equestrian and animal lover she lives in the country and reading, where she raises for children's dogs horses 17 cats chickens and occasionally sheep it's not really 17 cat so that was a little inside joke, but please join me in welcoming Professor pendry.
[00:02:08.760]Well, thank you very, very much Jeff for this amazing introduction i'm very happy that there was a slight correction in the total number of cats, there are in fact not 17 cats it's only seven.
[00:02:23.070]um first of all I wanted to thank Jeff and all the organizers and students and staff everyone who has been involved in organizing this amazing symposium.
[00:02:37.140]i've been very impressed with the talk so far really been wonderful to meet these wonderful colleagues and speakers and i'm just really thrilled to be here, so thank you very much for including me.
[00:02:50.160]My talk today will be about conceptual and pathway models of guiding research on identifying active treatment components of a eyes on stress related outcomes.
[00:03:04.440]Is it loud enough okay i'll hang out here a little bit more.
[00:03:11.580]That you set this up to.
[00:03:19.560]Thank you, there we go before we start, I would like to acknowledge everyone that makes this work possible This includes my graduate student at the human, animal interaction lab that are run.
[00:03:30.900]But also the funders very generous funding received for the studies that i'm going to be talking about, and that includes the.
[00:03:39.000]Research initiative and human sciences grant as well as Mars, while some who's generally supported the pet Pal study.
[00:03:47.430]Without them, this work would not be possible, I also want to thank the Whitman county humane society and clues pause, who is a regional partner from pet partners a national organization, who has provided a lot of the animal handling teams that we work with.
[00:04:06.840]So, thanks to the efforts, also have a lot of my graduates my undergraduate team.
[00:04:13.560]So a little background on my my talk what we're going to talk about today i'll give a little background on why i'm interested in university based a eyes.
[00:04:24.060]When i'm talking about as i'm talking about animal assisted interventions in general we've heard a lot about cognition of.
[00:04:32.550]dogs and we haven't really explored that much yet about the impact of those interactions with canine so that's what this talk is about mostly in university settings.
[00:04:44.850]will talk a little bit about what is missing in the hga literature with regards to those college and university populations and particularly what we do not know yet about animal assisted interventions in those settings.
[00:04:58.740]i'll touch on the human, animal interaction hypothalamic pituitary adrenal transactional model which is a model that is guiding.
[00:05:09.990]My research and i'm going to kind of take certain components of that model and illustrate why I think it functions, the way it does, by highlighting findings from two different studies to pet your stress away study and the pet Pal study.
[00:05:28.620]Most of my works is focused on salivary markers of HPA axis activity.
[00:05:35.280]And i'll be highlighting a little bit why I do, that what the underlying rationale is for my approach and why I think those types of processes are important.
[00:05:47.430]Well then, in the end, to give back to the model to sort of see how the results that I have found fit into the model and how it might inform future research design and that last piece is done through a model called test.
[00:06:00.780]Which is one that might be useful for some research endeavors that you may set out to engage in as well, so let's start with a little background.
[00:06:11.130]You probably are aware that there is a university student mental health crisis when you look at reports done by the national college health assessment team.
[00:06:23.160]We are very concerned, and so is the media about the rising trend in not just experiencing stress related mental health symptoms but actual the presence of clinical diagnosis, we see unprecedented.
[00:06:39.930]Rates of anxiety depression and other mental health condition incoming student population in fact as closest one to 445 students have.
[00:06:53.190]diagnosable disorders related to mental health, and we believe that stress plays a very important role in this, so.
[00:07:02.700]What we have also seen simultaneously is that because of those diagnoses and because of the large amounts of stress experience by students.
[00:07:12.060]We see that college counseling centers are absolutely overwhelmed with demand for their services, in fact, when we look at some prevalence data here, we see that the need for services to request for services has increased.
[00:07:26.640]Almost by 40% on average that's just in the United States, which is actually six to eight times the growth and enrollment now because these.
[00:07:37.230]centers cannot keep up with the demand.
[00:07:40.680]I think they are very excited about the possibility of offering animal assisted activities.
[00:07:46.380]And we know that in the last decade, these types of interventions animal assisted interventions have absolutely surge in popularity and implementation on college campuses.
[00:07:57.420]Now what's interesting as a prevention scientist i'm always interested in wanting to know that programs work before we implement them and scale them up.
[00:08:07.020]And that's not really the case with animal assisted interventions we have wide dissemination really outpacing the evidence for their efficacy.
[00:08:17.700]Now we recently are seeing randomized control trials that show effects on a variety of different outcomes that include students perceived stress.
[00:08:29.520]Some impact on mood particularly anxiety recently salivary cortisol and alpha amylase however it's really important to recognize that these are all based on very short exposures.
[00:08:42.360]In in the field in general I think there's a very limited range.
[00:08:46.800]Of the kinds of outcomes that we examine in selective domains, and also there's tremendous variability in the types of programs that are being offered right, ranging from you know five minutes exposure to a half hour exposure.
[00:09:00.600]programs that are conducted with small groups versus one on one, although those are quite rare interest, there are a tremendous amount of questions that remain on answer, and those are the ones that i'm interested in.
[00:09:13.590]I want to know what works for whom and under what conditions right that's, the key question i'm hoping to answer in my work.
[00:09:20.370]But I also want to know what are the active components, why are animal assisted interventions working and then, of course, also how, which are the outcomes that are effective and what are these pathways that are underlying these effects.
[00:09:37.200]Jeffrey Stevens: What are the implications for program design, implementation, evaluation and that's, of course, a prevention science perspective that I would like to bring.
[00:09:46.080]Jeffrey Stevens: To our field right, what do we need to know before we scale programs up what are the most efficient or effective types of programs at what time in what format for which population and what can we expect them to accomplish.
[00:10:01.290]Jeffrey Stevens: So in my case, I really am interested in can a eyes prevent these negative implications of university stress on mental health but also can they help.
[00:10:14.430]Jeffrey Stevens: facilitate academic success, and how can we best do that so let's first talk a little bit about the rationale for targeting stress and mental health for university students.
[00:10:26.700]Jeffrey Stevens: Number one emerging adulthood, as you probably know, is a period of heightened stress sensitivity.
[00:10:33.270]Jeffrey Stevens: Of elevated depressed mood an increased risk for psychiatric disorders, not just necessarily for college or university students per se, but just this developmental periods.
[00:10:44.400]Jeffrey Stevens: And we know that stress plays a role right, we believe that it plays a role in heightened negative emotionality.
[00:10:50.490]Jeffrey Stevens: Also stress plays a role in the development of psychiatric disorder.
[00:10:54.630]Jeffrey Stevens: And the way in which that is thought to occur is through transactions amongst physiological stress system right our stress system activities, as well as our cognition emotions in how we respond to stress or deal with allows or.
[00:11:08.880]Jeffrey Stevens: So, and that is kind of the nuts and bolts of the hai HPA transactional model that guides my research so according to this model.
[00:11:21.960]Jeffrey Stevens: There are a lot of different ways in which he I mean impact these processes so we know, for example, that from basic transactional stress.
[00:11:34.290]Jeffrey Stevens: theoretical models that stress is not just an event that occurs right, we have to interpret whether stressors are relevant to us and whether stress.
[00:11:45.870]Jeffrey Stevens: is potentially an event or occurrence that is going to overwhelm our coping resources, we know from prior models, I certainly don't want to.
[00:11:54.960]Jeffrey Stevens: Take claim to those, but we know that stress is appraised and when you appraise of the event.
[00:12:03.660]Jeffrey Stevens: As more stressful likely to overwhelm your coping that's when we see activation of what we call the HPA cascade.
[00:12:11.610]Jeffrey Stevens: And the role of human, animal interaction may be one through social support in that it may moderate that process of appraisal how we appraise of that stress or that's one potential way in which this could happen.
[00:12:26.820]Jeffrey Stevens: Now, in addition, we see that as the perception let's say, if you have activation of the HPA cascade It may be that, as you.
[00:12:39.630]Jeffrey Stevens: As you engage in further coping that may potentially influence, whether the HPA cascade feedback loop is adjusted to down regulate production of cortisol or whether you continue to appraise as that event as stressful which keeps that cascade active.
[00:13:01.380]There is of course sort of that feedback moment and we're going to talk about that a little bit more i'm just giving you some basic indicators of indicators of how this model.
[00:13:10.710]In my opinion, works so reappraisal of that stressor but also wants own physiological response rhian forms coping.
[00:13:21.150]And that either continues to engage the HPA cascade or it may down regulated and disruptive.
[00:13:29.910]Now, in another aspect of human, animal interaction, because human, animal interaction is more than social support either by the animal or the people who are with you to provide this hai experience.
[00:13:42.390]We see that there may be a portion of agi that.
[00:13:46.560]Is the pure physiological regulations, who touch and petting, we know that heading an animal tends to increase oxytocin, we know that just making eye contact with an animal can do that.
[00:14:00.840]And it is thought that just the production of ot can suppress HPA activation and may just disrupt this HPA cascade.
[00:14:13.170]So, again there's a variety of pieces of this model and we're going to touch on some of those and then in the end of the presentation we'll come back in to see where these different findings from our research work and where do they support this notion.
[00:14:28.890]there's also a role for expectancy right the extent to which one may believe that hai is indeed an effective stress release Sir.
[00:14:39.390]And the extent to which you trust that this will help one's own coping, and so the idea is that whether.
[00:14:48.150]That we would like to better understand whether expectancy can moderate again both the activation the cognitive appraisal the cascade and potentially down regulate that activity so.
[00:15:04.410]I wanted to mention that this model is based on sort of existing transactional coping theories, but also on a pretty thorough review of the empirical literature in the field of H Ai that is focused on salivary.
[00:15:20.130]Jeffrey Stevens: outcomes, particularly salivary markers of the stress systems.
[00:15:25.290]Jeffrey Stevens: So we're going to talk mostly about that HPA cascade and the role of touch in down regulating that cascade first and foremost, so that is done through the pet your stress away study findings which i'm going to share with you right now.
[00:15:43.650]it's not showing.
[00:15:46.380]Jeffrey Stevens: So the PETRA stress away program was a program that was conducted at our university and happening for quite a few years.
[00:15:53.610]Jeffrey Stevens: it's considered a universal prevention program anyone can show up and participate, although of course it's targeted to students.
[00:16:00.180]Jeffrey Stevens: It was offered by the dean of students office always done during final examinations and it really sort of approximated a 10 to 1515 minute supervised interaction.
[00:16:12.060]Jeffrey Stevens: With animals that were brought in from the local humane society, and these were both dogs and cats.
[00:16:19.830]Jeffrey Stevens: This program was in existence one before I decided to study it, but I really wanted to tie into a real life intervention because that's what prevention scientists do to see what the effects were of this program.
[00:16:34.350]Jeffrey Stevens: So the research questions are does 10 minutes of engagement in the pet your stress away program reduce negative emotion increase positive emotion and does it affect the activity of the HPA axis and the autonomic nervous system.
[00:16:51.120]Jeffrey Stevens: I really wanted to also know whether these effects were moderated by the presence of potentially students risk factors thinking that maybe students who are already experiencing a lot of stress may be affected differently, because we see that in the.
[00:17:03.570]Jeffrey Stevens: Broader literature on interventions and then I want to know what's the key ingredients like, why is this working, what is the piece that we absolutely need when we engage in a as organize them so.
[00:17:17.100]Jeffrey Stevens: Does participation in a 10 minute hai session causally effect negative emotion, mostly feeling anxious depressed irritable positive emotion feeling content.
[00:17:28.260]Jeffrey Stevens: So my prediction was based on, and this was done, the work that was done and started in like 2014 so there wasn't that much available but logical hypothesis would be helpful, like malthus's will be to say that, yes, increases.
[00:17:44.310]Jeffrey Stevens: Positive emotion and decreases negative emotion.
[00:17:47.460]Jeffrey Stevens: So what I wanted to do is I didn't want to just examine effects from the participants participants who showed up, I wanted to have some control.
[00:17:56.280]Jeffrey Stevens: Over the conditions that they engaged in so before the intervention to place, I went and recruited in undergraduate classrooms.
[00:18:05.820]Jeffrey Stevens: by talking about the fact that the p is a program was organized lots of students knew about this gave them a description of the program but also the study I asked them to consent to the study and complete a survey.
[00:18:20.460]Jeffrey Stevens: about their demographic characteristics, as well as their stress related function.
[00:18:25.980]Jeffrey Stevens: Now, this was going to be an independent groups design, where I had a pre and post test, and so I randomly assigned people to conditions which i'll tell you more about in a moment.
[00:18:35.820]Jeffrey Stevens: And we did this ahead of time before they enrolled so they had a survey that had a code which condition they were assigned to and they were not aware of what that current was they were blind to that condition.
[00:18:48.090]Jeffrey Stevens: So the first condition was just participating in the 10 minute program and we had arranged with the staff.
[00:18:56.040]Jeffrey Stevens: That we would have control over entry and exit of the program while the whole university is doing their thing we had a set of students coming to us to be led in and out of that program condition.
[00:19:09.180]Jeffrey Stevens: Just blending in with everybody else, but never the last being watched to being able to control their exit and entry the control condition was.
[00:19:21.240]Jeffrey Stevens: Viewing a slide presentation of the same animals really nice challenge for a graduate student when in the morning, you find out that some of the animals are different.
[00:19:31.410]Jeffrey Stevens: You have to like we actually responded to that and got all the pictures for.
[00:19:35.700]Jeffrey Stevens: The animals who were we'd gone in before and taking pictures of all the animals, and there was one swap and so that caused a little stress in our land, but we made it through so and.
[00:19:46.260]Jeffrey Stevens: I were the reason we did that, as we showed the students.
[00:19:50.340]Jeffrey Stevens: The slides with the idea that we were asking them which animals, they liked best to deceive them to think that that's the ones we would let them interact with most because we needed this excuse.
[00:20:02.820]Jeffrey Stevens: For them to spend 10 minutes of looking at still images of the same animals like Why would we have to do that and we said no we're going to go and give you an opportunity to indicate when you like best.
[00:20:14.970]Jeffrey Stevens: And then there was a non treatment condition which was 10 minutes of waiting and i'll get to in a second how we manage that, so they filled out the survey they.
[00:20:24.900]Jeffrey Stevens: explained a little bit more who they were and, as you can see, as expected in is quite common most of our sample was white female mostly underclassmen.
[00:20:35.160]Jeffrey Stevens: We also gathered information using reliable tools to examine depression, anxiety perceived stress and worry and We calculated whether.
[00:20:49.200]Jeffrey Stevens: participants were at risk, for having a stress related symptoms already.
[00:20:54.690]Jeffrey Stevens: We asked about pet ownership and exposure and then because the intervention was already taking place at that time.
[00:21:02.190]Jeffrey Stevens: We had our conditions run at particular time points so we had to find out after they were excited.
[00:21:09.330]Jeffrey Stevens: Are you able to come at 10 o'clock because that's when the experimental conditions.
[00:21:13.890]Jeffrey Stevens: Right, so we lost some people in that process, so we started out with 374 people surveyed and only 182 of them were actually able to come that day they might have had a work conflict or something else going on.
[00:21:27.840]Jeffrey Stevens: So when they arrived, we had set up these dividers so that they couldn't see the animals, they couldn't see anything they were had a special label on when they came to campus we told them where to come.
[00:21:40.140]Jeffrey Stevens: And then they checked in with our research assistants, so they had we made sure that there was no other exposure before they arrived, and this is for the experimental group.
[00:21:50.700]Jeffrey Stevens: So when they arrived, one of the first things they did is our pre test was a momentary report of emotion, and this was a measure that we've used before and looking at emotional states in our equine.
[00:22:03.270]Jeffrey Stevens: Research very simple 25 questions, how are you feeling right in this moment on the scale from zero to three and they just completed that survey.
[00:22:14.220]Jeffrey Stevens: Just right before they walked in the door, so we timed everything very, very careful, they will be all ready to go everybody had their clipboard they assessed moment to moment the emotion states and then went in for their 10 minute intervention.
[00:22:30.660]Jeffrey Stevens: And we already know that when we factor analyze these questions, we come up with content feelings of anxious feeling anxious feeling irritable and feelings of depression.
[00:22:41.550]Jeffrey Stevens: feeling depressed those are the four factors that we examined so they would go in did that first espn and exactly 10 minutes after they were engaging with animals, which was a fairly.
[00:22:54.720]Jeffrey Stevens: I don't want to say free for all that, because that sounds bad, but it really was engaging in small groups, just as old outwards.
[00:23:03.210]Jeffrey Stevens: Just as all those people, you see, in the back in the line they would come in and also interact with the animals right, so our participants were into spring spring into the same intervention, but we were watching them.
[00:23:15.270]Jeffrey Stevens: So exactly 10 minutes later they filled out there second DSM, which is the same number of questions.
[00:23:23.790]Jeffrey Stevens: Now our control group had different labels and so when they came to campus they were told to come to a little sort of a bathroom door not into the main engine and we put them.
[00:23:34.950]Jeffrey Stevens: said ask them to sit down and just ask them to breach the animals, they would most likely to interact with but we made sure that they filled out an asm at the beginning time the slide presentation of take exactly 10 minutes.
[00:23:50.490]Jeffrey Stevens: And they just circled or redid the animals, they were interested in we tried to keep that process very low key but nevertheless they were looking at slides but you're still animal pictures of the same animals.
[00:24:02.520]Jeffrey Stevens: And then exactly 10 minutes later they took their second DSM and after that they were released to go to the program they thought they were being assessed to the program participation, but they weren't right.
[00:24:14.310]Then we had the no treatment group and we just put them right there in a separate room separate area and we said gosh you know it's just very busy you're just gonna have to wait about 10 minutes.
[00:24:24.720]Just wait right here, please don't talk just kind of be quiet and wait until it's your turn and same thing we had them completely asm.
[00:24:33.090]Before exactly 10 minutes later they took the other one we said oh Would you mind doing that again just before you're going in because it's been it's been some time waiting, and so we essentially assess their momentary emotional states in response to quietly sitting and waiting.
[00:24:49.650]Jeffrey Stevens: So both those control group and non treatment participants were then lead in and we're given a little slip to go to the front of the line.
[00:24:58.530]Jeffrey Stevens: So what we do with those data well We calculated our composites and then we just did some very basic three group comparison on mean levels of these different factors okay.
[00:25:11.100]Jeffrey Stevens: And so, when people always say don't show numbers but I can't help myself, so I just want you to know that I am going to show these.
[00:25:21.150]Jeffrey Stevens: graphs as well, so For those of you who want to know what significant and how much, and what these effect sizes are.
[00:25:28.680]Jeffrey Stevens: Like number wise here they are, we found that the team is a group, the people who had 10 minutes of hands on interaction had significantly higher levels of feeling content.
[00:25:40.470]Jeffrey Stevens: lower levels of feeling anxious lower levels of feeling irritable and those effects work statistically significant.
[00:25:48.030]Jeffrey Stevens: So, first of all, of course, we made sure to test whether everybody was the same at time, one which they were here, you see the three group mean levels of feeling content.
[00:25:59.160]Jeffrey Stevens: And here are the post test levels clearly indicating that while everyone had slight improvements in feeling content, the difference between the hands on condition was significant.
[00:26:12.030]Jeffrey Stevens: Between the with the control group and the non treatment group, but clearly the mean levels were significantly higher in hands on.
[00:26:22.290]We looked at the same information for emotions relating to feeling anxious found that anxiety anxious feelings reduced throughout the whole sample but most significantly, so for the group receiving the regular hands on interaction.
[00:26:38.550]Similarly for Eric being irritable same levels of time one.
[00:26:43.410]Jeffrey Stevens: gradual decrease so some exposure in whichever these conditions were shirts and within person effects, but really mean level wise we're looking at the greatest bang for the buck, so to speak, by engaging in 10 minutes.
[00:26:58.080]Jeffrey Stevens: In a hands on way, and this may seem very expected and logical and I would agree, but it nevertheless needed to be demonstrated so we did not find similar.
[00:27:12.210]Findings for feeling depressed I mean if you bought eyeball the numbers, it looks like this might be a significant change in their work within person effects, but nothing comparing the group mean levels that showed up significant none of these work.
[00:27:28.920]Jeffrey Stevens: So, based on that we said well compared to watching a 10 minutes live presentation or sitting in a waiting area for 10 minutes.
[00:27:36.240]Jeffrey Stevens: Participation in the 10 minute program that's hands on interaction significantly reduced feeling anxious and irritable and increased feeling content, so the question then is well why.
[00:27:47.550]Jeffrey Stevens: Right, what is it about that 10 minute interaction is it the hands on piece.
[00:27:53.250]Jeffrey Stevens: Now, to be fair, they are getting hands on the interaction, but they're also getting a lot of other things right they're getting social support.
[00:28:01.710]Jeffrey Stevens: From their peers potentially social support film The folks who are handling the animals right so it's not just touch or hands on.
[00:28:10.860]Jeffrey Stevens: There are a lot of features that are embedded in that interaction is it seeing the animal and enjoying.
[00:28:17.940]Jeffrey Stevens: sort of what the animal is is sort of portraying like we don't know what exactly it is right, so that's always a board when I want to understand what goes on sort of you know what's the key component.
[00:28:30.120]Jeffrey Stevens: So study to we said well let's change it up a little bit and let's add another condition right, I also feel like sometimes non treatments conditions are a little bit the low hanging fruit of research so.
[00:28:46.050]Jeffrey Stevens: I decided that it would make sense to try as best as we can to isolate the impact of touch by having the regular hands on condition the slideshow condition the same, but then having people come in, say, wait right here.
[00:29:04.290]Jeffrey Stevens: They can't touch the animals, they can see the animals but they're not still images right they're moving and they're seeing their peers engage.
[00:29:12.690]Jeffrey Stevens: Now I don't design this because I ever expect to have a program that would offer just this right i'm purely doing this for the research purpose of trying to tease out.
[00:29:23.820]Jeffrey Stevens: What that active component is, what do you need in order to have an effect of participation in an H in an animal assisted intervention.
[00:29:33.120]Jeffrey Stevens: So many almost identical procedures with regards to recruit trends and then dental procedures in terms of testing those emotional states and, here are some of our findings, I will leave my numbers be so equal grooming levels of feeling content at time one.
[00:29:56.610]Significant increases in feeling of content in comparison to the slideshow condition, but, as you can see, watching and waiting seem to also increase somewhat levels of content to similar levels as the.
[00:30:16.290]condition that was focused on the full Monty right hands on interaction.
[00:30:22.530]We see similar results for feeling anxious.
[00:30:26.340]Reductions in anxiety for three groups mean levels of time, one where the same at time to, we see that the hands on condition.
[00:30:35.670]has significantly lower mean levels of anxious feelings compared to the slide current condition, but not significantly to the watch and wait group.
[00:30:45.450]For irritable we see almost identical results showing significant decreases in feeling irritable definitely compared to the slideshow condition, but not for the watch and wait.
[00:30:57.720]There was something going on for them to stand in line and watch others now whether that is anticipation.
[00:31:06.570]For just seeing others enjoy these interactions as enjoyable or just seeing the animals might be enough, as long as they're not still images again we don't know.
[00:31:17.400]Again, we did not show any significant effects by comparing mean levels on feeling depressed.
[00:31:25.620]So that didn't make us wonder a little bit because, as we were engaged in these interactions we notice, and this is total anecdotal right students would come out of that intervention after the assessment you know with seemingly.
[00:31:41.220]sort of different behavioral responses, some were really positive showing positive behaviors talking about how excited there were, and then there was a group who just seemed.
[00:31:53.970]kind of irritable and angry and not happy and we just didn't couldn't exactly understand why, but we decided, and this was after the fact, to.
[00:32:08.850]Jeffrey Stevens: sort of building on this to also see if there were any moderations going on, by having already stress related symptoms.
[00:32:18.300]Jeffrey Stevens: Again we had set out to measure some of those web, since we were finding main effect we said well let's explore whether there are any differences that.
[00:32:28.140]Jeffrey Stevens: Differences by level of stress related symptoms right and we did that initially by looking at the feeling of depressed sample so here's what we found.
[00:32:39.960]Jeffrey Stevens: So this is the same same sample We found that when we use the back, depression inventory to identify those students who were in experiencing clinical levels of depression.
[00:32:54.240]Jeffrey Stevens: We found that while at time one they were all with very similar levels on all of these emotional factors.
[00:33:02.670]Jeffrey Stevens: As the intervention took place after 10 minutes, the students who were.
[00:33:09.870]Jeffrey Stevens: Officially, in the realm of having clinical depression we're feeling very irritable much more likely to be depressed and much more likely to be anxious after they were standing in line waiting.
[00:33:24.000]Jeffrey Stevens: So if they were in the group that experienced the hands on interaction right away everything was good if they were.
[00:33:32.190]Jeffrey Stevens: asked to wait for 10 minutes, the students who had high levels of depressive symptoms and who were classified as in the clinical depression range.
[00:33:42.840]Jeffrey Stevens: Really struggled with that now, you might think well Okay, why is that important well it's important because, when we from a prevention science point of view, if you are having.
[00:33:54.450]Jeffrey Stevens: An intervention like that, where you have six 700 students showing up and you've got all these animals and all these teams people sometimes stand in line for an hour.
[00:34:03.630]Jeffrey Stevens: Sometimes it's cool you know around the corner, but sometimes it's right there and that's really hard potentially for students who are already experiencing stress related symptoms and.
[00:34:15.900]Jeffrey Stevens: I wouldn't say that's true in general, because we haven't tested that but it's certainly true for students suffering from depression that altered, their experience potentially afterwards they started out at a very different level after waiting alright, so the question that I.
[00:34:35.790]mentioned earlier right does 10 minutes of this interaction effect emotion States I think we've seen this, but I also wanted to know about.
[00:34:45.540]Jeffrey Stevens: Whether it affected activity of the HPA axis right, so what is the effect of the hands on interaction versus the slides versus the waitlist versus standing in line.
[00:34:58.800]Jeffrey Stevens: So let's talk a little bit about why i'm interested in that, and why I think it might have something to do with it well, first of all it's probably well known that.
[00:35:09.960]The HPA axis is made up of the hypothalamus pituitary and the adrenal gland which is located just a little bit above the kidney and we know that exposure to a stressor activates production of CRA it travels from the hypothalamus to the pituitary gland where the arrival of CRA.
[00:35:35.190]Jeffrey Stevens: leads to the production of ACTA ah that ends up prompting the production of cortisol to the adrenal gland which, then, is that back into the bloodstream.
[00:35:46.410]Jeffrey Stevens: Now this process doesn't just go on when you're there's always a pulsating die you're an old pattern of production in this way, but there are individual departures from the regular amount of.
[00:36:00.330]Jeffrey Stevens: cortisol present in the system based on the woman's daily experiences and the beauty, is that we can test the amount of cortisol in the system by looking at salivary levels and the same is true for alpha animals.
[00:36:15.360]Jeffrey Stevens: So what better to collect that right so just a little bit more information about why I want to do that, as you can see, on the left.
[00:36:25.050]Jeffrey Stevens: it's important to know that diurnal cortisol patterns exist, so all this means is that, on a daily basis.
[00:36:32.190]Jeffrey Stevens: There is a circadian rhythm and we know this from decades of research, when you wake up in the morning levels are relatively high.
[00:36:39.570]Jeffrey Stevens: You get a boost in response to waking up you have fairly rapid decline in the first hours after waking and then a more gradual decline to almost zero levels.
[00:36:50.040]Jeffrey Stevens: By the end of the day, which makes sense right you don't want to be all pumped up with cortisol right before you go to bed.
[00:36:56.370]Jeffrey Stevens: Now about little over 70% can be predicted by time of day, if I take your cortisol measure right now.
[00:37:03.780]Jeffrey Stevens: If I know what it was yesterday, or what time of day was taken yesterday, I can based on this curve predict what your levels will be in this moment about 72% are driven by time of day, following that diurnal pattern, and what i'm showing you is an adaptive healthy.
[00:37:20.850]Jeffrey Stevens: Now then there's this idea and I drew this little in the hokey ways is a little bit kindergarten but just for purposes of explaining.
[00:37:29.280]Jeffrey Stevens: there's momentary influences as well right that's the other 28%, and so the idea here is that if you're exposed to the stress or the body needs to mobilize and response, it does all those same activities CRA production prompts.
[00:37:46.020]Jeffrey Stevens: i'm sorry the hypothalamus produces CRA its arrival in the pituitary gland starts to me to AC T H production it ends up with that cortisol cascade that you saw on that earlier model.
[00:38:00.330]Jeffrey Stevens: Now, the idea is that we all want to have a fine tuned feedback loop right.
[00:38:05.340]Jeffrey Stevens: If you are experiencing a stressor you want to size that up that's where cognitive appraisal comes in.
[00:38:12.000]Jeffrey Stevens: you decide who can I handle this yes or no, if the answer is no, the cascade keeps going because it's sort of helping you right it's helping you mobilize resources to engage with that stressor.
[00:38:25.800]Jeffrey Stevens: If the answer is yes i'm OK it down regulates and just over time, you should recover to get back to whatever your diurnal rhythm what's right so.
[00:38:39.480]Jeffrey Stevens: And we know that it also should work, the other way around right if you're relaxing you should potentially have.
[00:38:47.730]Jeffrey Stevens: slightly lower levels of cortisol, then we have predicted time of day, but that research is really not very well developed but that's the one that i'm banking on from my work.
[00:38:57.210]Jeffrey Stevens: I want to know, is it possible to down regulate through ha out right, so this whole idea of doing so is based on our knowledge from many years of research done, the fact that sometimes.
[00:39:14.070]Jeffrey Stevens: dysregulation of the feedback loop occurs right for some individuals either, if you have been chronically exposed to stress, or to a massive acute stress, or it can dis regulate this nice little feedback loop that fine tunes what you need.
[00:39:31.980]Jeffrey Stevens: Over a period of time know what it does it over rules, the realization that you have cortisol showing up.
[00:39:40.830]Jeffrey Stevens: In the in the hypothalamus we don't need any more court, you can down regulate car rage and down regulate ACTA ah we're fine we're doing well and our response, it says no i'm going to keep feeding that cascade because you probably need to have more sort of.
[00:40:05.460]Jeffrey Stevens: You know tools to manage that stressor now if we see dysregulation from that feedback loop over time.
[00:40:14.310]Jeffrey Stevens: What we see is that rather that you have this nice diurnal rhythm that I have explained.
[00:40:20.370]Jeffrey Stevens: What we see is that very gradually, what is your normal, healthy diurnal level that you're given to manage throughout the day to deal with most stressors starts to change.
[00:40:33.300]Jeffrey Stevens: It gradually sets the point at a different level, because the body wants homeostasis if I asked you 10 times to activate defied stressors at some point that says look, this is exhausting.
[00:40:45.960]Jeffrey Stevens: i'm just going to give you more to begin with right so you're resetting the set point of your diurnal pattern, so you don't have to work that hard one stressor comes along.
[00:40:57.510]Jeffrey Stevens: And again through this body's desire for homeostasis we very gradually see that there becomes a new altered set point and that's what we call our static load it's stressing the stress system.
[00:41:11.190]Jeffrey Stevens: To do more in overtime it changes to accommodate that without having to work so hard each and every time.
[00:41:18.390]Jeffrey Stevens: So what we see, for example, we know this from other research, this is not my research, we know that individuals who have clinical depression, for example, see that they have altered.
[00:41:31.950]Jeffrey Stevens: diurnal patterns, we see that they have altered.
[00:41:36.480]Jeffrey Stevens: Responses to stressors so one can either have higher baseline levels, you can not have a good day or no feedback system, so instead of stopping the cascade you over respond, you could also be so it's like your system is so exhausted, that in the.
[00:41:55.980]Jeffrey Stevens: In the face of a stressor you have a blunted response and barely moves it barely gives you anything what you need.
[00:42:03.570]Jeffrey Stevens: or right so there's diurnal implications and reactivity implications of chronic and frequent exposures and so again i'm just warning you for the kindergarten level drawing here, I did this last night.
[00:42:19.200]Jeffrey Stevens: So let's say you have this sort of kind of.
[00:42:24.030]Jeffrey Stevens: Somewhat flat not great day you're an old pattern, according to this adaptive example right so you're a little flat.
[00:42:34.110]Jeffrey Stevens: So theoretically speaking, you should be able to through momentary down regulation of the system, potentially, over time, as you do this more frequently, maybe, rather than having Alastair I can load.
[00:42:50.220]Jeffrey Stevens: move the set point to some of the levels we just saw maybe we can bring this back to where it needs to be because.
[00:42:58.410]Jeffrey Stevens: If you are frequently in a relaxed state, maybe over time, the body stops this sort of higher flatter panel.
[00:43:07.020]Jeffrey Stevens: pattern right so it's the opposite me, and this is just weeks, but it could be months we don't know what it is it's just a theoretical idea if you can mess up the system, why can't we recuperate from it through relaxation.
[00:43:21.690]Jeffrey Stevens: Right and that really is in many way the idea behind doing frequent regular exposure to relaxation activities through a eyes.
[00:43:31.200]Jeffrey Stevens: If you can show that we down regulate cortisol which we could see after 10 minutes right.
[00:43:37.830]Jeffrey Stevens: We want to be able to do that and I shouldn't give it away we haven't seen that we have not seen that let's see if that happens so theoretically, you should be able to alter dire know patterns to more adaptive once through frequent.
[00:43:55.380]Jeffrey Stevens: Down regulation through hai right, so the next question does 10 minutes of hands on interaction down regulate activity of HPA axis.
[00:44:06.120]Jeffrey Stevens: Now there are other salivary markers that while you're at it, you can you know collect enough saliva to also examine others now, as you can see here.
[00:44:18.600]Jeffrey Stevens: alpha amylase is one of those, and this is a little bit more you're quick responder.
[00:44:23.820]Jeffrey Stevens: is actually having an opposite pattern to HPA axis activity it's a relatively new analyze it hasn't been that commonly explored in the hdi literature.
[00:44:37.320]Jeffrey Stevens: We know that it's diurnal pattern is opposite of that HPA axis activity, we know that it peaks very quickly after exposure to a stressor and we know that it expand a response, both.
[00:44:52.590]Jeffrey Stevens: arousal that's positive, as well as as negative and we know it has some implications, the similar kind of dysregulation examples in alpha amylase are linked to some other stress related disorders, that we are concerned about in in college students.
[00:45:09.330]Jeffrey Stevens: So, like I say when we examine both of those analyze at the same time, we can look at each analyze individually, but we can also look at the ratio between these two.
[00:45:27.900]Jeffrey Stevens: salivary markers because they each represent slight in different systems right.
[00:45:33.030]Jeffrey Stevens: And this is something that's relatively novel it's it's just beginning to see to be present in the literature is to calculate the ratio of alpha.
[00:45:44.070]Jeffrey Stevens: amylase over cortisol because it shows that it is linked to a variety of stress related symptoms it's fairly limited it's mostly in the reactive round, but is nevertheless an interesting phenomenon so.
[00:45:59.850]Jeffrey Stevens: How do we calculate that well all of these.
[00:46:02.880]Jeffrey Stevens: processes can be if you're collecting salivary samples over a period of time either throughout the day.
[00:46:10.080]Jeffrey Stevens: Or, in response to stress, or you do it in the morning, in the middle and then, in response to stress, or you have to keep the timing and my.
[00:46:17.280]Jeffrey Stevens: If you have multiple data points you can calculate essentially the area under the curve right, so this is called the trap resort formula, the Polygon method what you're doing, depending on how many samples you collect you calculate essentially.
[00:46:34.110]Jeffrey Stevens: From those multiple markers a single parameter right, which also helps you, with your statistical power.
[00:46:44.310]Jeffrey Stevens: And what you're calculating is the change over time, but also the intensity right by understanding how much of this analyze is in the system in the time period that you are exam.
[00:46:59.010]Jeffrey Stevens: So this way you can detect who's overreacted.
[00:47:03.330]Jeffrey Stevens: under-reacting right and you could look, both at the entire amount in the system for waking hour, but you could also look at the change there in by looking not including the starting point of zero right, you can just look at the actual value over time.
[00:47:19.980]Jeffrey Stevens: Alright, so what we did we have now are four different conditions same conditions as before, same recruitment method, we have one condition.
[00:47:32.910]Jeffrey Stevens: Where we have 10 minutes of exposure to the exact same procedural hands on interaction.
[00:47:40.620]Jeffrey Stevens: 10 minutes of proximity, this is standing in line waiting and watching 10 minutes of what we've been relabelled imagery because it's really just silent.
[00:47:51.840]Jeffrey Stevens: Still images and then our waitlist condition and we reintroduced that weight this condition, because this is the first time, we were looking at the Court and in that.
[00:48:01.950]Jeffrey Stevens: In that situation you want to know if it's if it's impact is above and beyond, doing nothing right so again, we had our sample.
[00:48:12.330]Jeffrey Stevens: recruiting in the same way, but what we ask people to do is when we did our recruitment meeting we showed them how to sample.
[00:48:18.750]Jeffrey Stevens: And we gave them a sampling kit to take on their way along with some activity report, so they could write down what they ate and when how much coffee when they got up what they did the night before mean we collected absolutely everything.
[00:48:33.510]Jeffrey Stevens: And minutes I better go so um so what they did is they showed up Similarly, in the same conditions they.
[00:48:43.230]Jeffrey Stevens: dropped off their six sample or no not 600 sorry that was an exaggeration there one sample of baseline cortisol that they took immediately upon waking they filled out the as the espn forms and then they went to their respective conditions.
[00:49:00.930]Jeffrey Stevens: With cortisol we have a 25 minute lag right, so if something happens takes about 25 Minutes to show up in the cortisol saliva.
[00:49:12.510]Jeffrey Stevens: In the saliva So what we did is we sampled The pre test sample was taken 1015 minutes after the intervention or 25 minutes after the start.
[00:49:24.930]Jeffrey Stevens: And we timed everything very, very carefully right, and these were linked to the sm.
[00:49:31.050]Jeffrey Stevens: So we had for each individual three samples, and yes, for all of our we have a freezer full of spirit we have you know thousands like close to 10,000 samples that we've collected in various different studies.
[00:49:44.820]Jeffrey Stevens: So does the touch condition resulting down regulation of cortisol we predicted that it works don't show numbers but i'm doing it anyway.
[00:49:54.360]Jeffrey Stevens: i'm going to direct you, though, to the circled areas what we found is the first of all, this is a regression model where we use dummy variables for each condition.
[00:50:04.680]Jeffrey Stevens: So the hands on condition is the reference condition that's why all of the weather observation weather slide weather waiting are in comparison to the weather hands on right and because all of the values for the cortisol parameters are log transformed.
[00:50:26.070]Jeffrey Stevens: You see, in the circle a representation of the changing cortisol in a percentage, rather than the coefficients are difficult.
[00:50:35.370]Jeffrey Stevens: to interpret so just bear with me for a second in the first model.
[00:50:40.500]Jeffrey Stevens: We just mostly looked at condition as the predictive but, in the second model we also calculated the slope.
[00:50:48.030]Jeffrey Stevens: Of the cortisol value for those individuals from when they woke up to when they showed up we controlled, for the time of day and then for their pre test right.
[00:50:59.910]Jeffrey Stevens: So we found that compared to the standing and watching in line that the people who got the whole thing the hands on condition had close to 30% lower cortisol levels at the end of the 10 minute intervention.
[00:51:17.010]Jeffrey Stevens: For the slide to show the comparison between those with the hands on condition and those watching slides was 27 and then again for the ways condition 27.
[00:51:28.620]Jeffrey Stevens: And you can see, all of these differences by condition in post test cortisol level.
[00:51:34.290]Jeffrey Stevens: were significant and here's what the trajectory of the predicted scores look like, so you have your regression model with predicted score controlling for all of these other factors that might lead to some confounding.
[00:51:47.640]Jeffrey Stevens: Here you see these patterns on the bottom line is the hands on condition which you could see very clearly based on these data they all start out at the same levels of cortisol.
[00:51:59.310]Jeffrey Stevens: And then that's common because they all work up somewhere, at the same time, or we controlled for that.
[00:52:06.210]Jeffrey Stevens: And then we see that, over time, in response to the intervention, the folks in the hands on condition ended up with the lowest levels of cortisol.
[00:52:15.960]Jeffrey Stevens: Right now i'm going to switch a little bit to looking at the Alpha amylase for a moment, as you remember the Alpha emily's patterns are opposite right, and so what I used a very similar methodology to look.
[00:52:32.310]Jeffrey Stevens: At the extent to which alpha amylase would be increased or decreased.
[00:52:37.950]Jeffrey Stevens: Because what we wanted to see is increased levels of alpha amylase and whether that means positive or it means arousal whether it's necessarily positive it's a little bit of a leap, but for now.
[00:52:51.000]Jeffrey Stevens: So we at least see that there are some reactivity, and so what we're noticing number purely looking at post-test alpha amylase levels is that compared.
[00:53:00.810]Jeffrey Stevens: To being close to them, looking at the slides are looking at the waist weightless condition.
[00:53:07.380]Jeffrey Stevens: Once we control, also for the cortisol response right, we see that there are significant differences in the sense that post alpha amylase levels are.
[00:53:19.950]Jeffrey Stevens: considerably in significantly higher compared to all of the comparison conditions.
[00:53:26.850]Jeffrey Stevens: Now we also see that the coordination, which is likely to happen between the HPA axis and the autonomic nervous system.
[00:53:36.150]Jeffrey Stevens: is happening, so the top part of the line still shows you the numbers of the same results so just look at the chart below the line that indicates that alpha amylase cortisol ratio, and here we see that the overall.
[00:53:50.880]Jeffrey Stevens: finding is that the higher coordination of the response during the intervention is experienced most in the hands on condition.
[00:54:01.470]Jeffrey Stevens: And that's exciting, because that means you have lower cortisol and higher our families and that's clearly the kind of adaptive response, or the you know response that we would like to see.
[00:54:12.720]Jeffrey Stevens: So I know that i'm how many minutes, do I have I five yes okay so we're going to get there, so I don't think I need to reinterpret or restate this again, so the question is.
[00:54:25.860]Jeffrey Stevens: Given this finding is more better right just should we just do this more often right more intervention longer periods of time more dogs more people I don't know.
[00:54:36.030]Jeffrey Stevens: So is it better, but is it also better above and beyond what a lot of colleges are already doing, because people are doing stress prevention programs.
[00:54:45.840]Jeffrey Stevens: So why do we need to bring in animals, unless we can demonstrate it they're better than what we're already doing right so that's a big question I have and that's the pets for promotion of academic life skills.
[00:54:56.940]Jeffrey Stevens: So i'm going to have to be relatively quick, but this is a four week program that we designed, where, for four weeks.
[00:55:06.900]Jeffrey Stevens: Students come in and are exposed to various levels of hai or psycho educational content that is evidence based.
[00:55:16.470]Jeffrey Stevens: Now we examined impact on students executive functioning study skills de urinal cortisol but also buffering and recovering effects against a real life stressor so.
[00:55:30.210]Jeffrey Stevens: hold on one second i'm going to skip through reads Long live animation all right first condition hundred percent academic stress management.
[00:55:41.400]Jeffrey Stevens: These people didn't know this, but we told them they're receiving various levels of hai.
[00:55:46.680]Jeffrey Stevens: At various time points in your case zero well they did get it at the end right and reset at various time points so these students.
[00:55:54.780]Jeffrey Stevens: were four week long one hour sessions of just really fabulous evidence based stress management content, the second condition was.
[00:56:04.080]Jeffrey Stevens: All animals congratulations, we didn't say that to them, but they were getting 100% interaction with head partner, animals and the third conditional isn't exactly equal of both 30 minutes and 130 minute of the other but kind of interwoven to one another.
[00:56:20.310]Jeffrey Stevens: So we had a little over 300 people folks were blind to their condition one hour sessions on a weekly basis always done.
[00:56:28.950]Jeffrey Stevens: We were a little bit control freaky about this because that's how I operate same time of day same room same staff same assessments same facilitator saying partner team.
[00:56:40.650]Jeffrey Stevens: We really tried to make sure that there was absolutely no contamination people were in different buildings when they would show up or different.
[00:56:48.810]Jeffrey Stevens: didn't see one another, when they were doing assessments, even though we used all the same rules and so on, and we had highly tightly adhere to scripts and everything that we did was timed in 32nd intervals so.
[00:57:04.410]Jeffrey Stevens: attend for workshops they had three assessment periods pre post and follow up six week later.
[00:57:11.940]Jeffrey Stevens: They had to collect six salivary sample so we could calculate a urinal cortisol but do that three times pre test hostess and six weeks later, and then we collected another 16 reactivity paradigms in response to some of these activities.
[00:57:27.450]Jeffrey Stevens: Everything was recorded, and so we have, I think it's 28,000 minutes of dynamic and try attic data for you to come and help me code if you're interested.
[00:57:38.970]Jeffrey Stevens: The themes for the conversations and the content we're stress management motivation and goal setting benefits of sleep and test anxiety and these were evidence based interventions.
[00:57:51.690]Jeffrey Stevens: psycho educational interventions that are offered on our campus of time, so here, you see the timeline right, this is the room where it took place that was very quick.
[00:58:01.620]Jeffrey Stevens: This is the room where to place a big Center table cameras set up in the ceiling stations and then everything happened at the beginning, I didn't.
[00:58:11.790]Jeffrey Stevens: Have the beginning at the end so starting with a meet and greet either with or without dots you got a content, presentation, either with or without dodge or no content, presentation at all.
[00:58:24.720]Jeffrey Stevens: You had some activity or reflection no dogs or with dogs and then again, you could see that the asm group got nothing with regards to hai that ha oh group means human, animal interaction only.
[00:58:39.960]Jeffrey Stevens: And they might have talked about stress, sometimes, but if there was no slides no education nothing right and for the middle group they did a little bit of both so we covered all the same content but did it as fast as i'm doing right now.
[00:58:56.880]Jeffrey Stevens: So all of our handler dark teams 31 handler dark teams, mostly large breeds all pet partner certified and we would have several teams coming in during each of these sessions.
[00:59:11.220]Jeffrey Stevens: And here are all of our partner dogs.
[00:59:15.720]Jeffrey Stevens: So.
[00:59:17.610]Jeffrey Stevens: Again, mostly white female underclassmen.
[00:59:22.860]And we over recruited for students with stress related symptoms, because we wanted to know who potentially was at risk for developing mental health issues, particularly in light of our findings, so we had a third of our sample.
[00:59:39.690]Jeffrey Stevens: being identified as high risk.
[00:59:42.180]Jeffrey Stevens: Okay, so i'm just showing you what are some of the other measures that we looked at and which measures we used.
[00:59:51.030]Jeffrey Stevens: You probably can see, these are all well validated common measures, particularly those that we use for executive functioning as a well known one and, of course, all the mental health outcomes.
[01:00:02.940]Jeffrey Stevens: So results if I can get to them that would be great so our research question, what is the effect of exposure to the four week program by condition let's first talk about dying or know cortisol because I think that's.
[01:00:16.770]Jeffrey Stevens: A very exciting one Okay, so what we did is We calculated those area under the curve, but we did that both with respect to ground as well as respected increase right for each parameter, so we have six samples pre test six samples post us six samples.
[01:00:39.180]Jeffrey Stevens: At follow up right so those six samples were collected over a two day period slight variation in maybe time of the day, and so, based on those six We calculated a parameter, so we have two parameters for each time points.
[01:00:53.670]Jeffrey Stevens: So here's what we found so for those participants who for four weeks long experience both human, animal interaction and psycho educational content we saw that there was a significant difference in their AUC cortisol level.
[01:01:13.920]From from ground compared to the other conditions and here to we're doing a regression model.
[01:01:20.940]Where this is compared to the reference condition, which is the asm group right, so the group who got no animals at all.
[01:01:29.100]So compared to not receiving any animal interaction that he is he group, the ones who got the combination shows the greatest.
[01:01:38.520]reduction or let's say the lowest AUC cortisol levels now, these were all controlled again for the diurnal slope that was averaged over the two day period, and also the amount of time that they were awake right because time of day matters.
[01:01:55.140]Jeffrey Stevens: And then they're a uc under the curve and a pre test right, so this is our post test data, so you could see we're controlling for what their average levels of cortisol.
[01:02:09.480]Jeffrey Stevens: average level of cortisol was at the beginning of the intervention so we're really purely looking at the time that the cortisol change over time.
[01:02:20.370]Jeffrey Stevens: Then we found a very similar effect for our follow up data, so this was done six weeks after the intervention and that.
[01:02:28.170]Jeffrey Stevens: Similarly, we controlled for a pre test cortisol levels and notice that those compared to the asm condition, who did not receive animals.
[01:02:37.770]Jeffrey Stevens: showed lower cortisol levels at follow up, we did not find any moderation by risk status for either of these outcomes, so this equates to about 14% or 12% for that first time period in.
[01:02:52.710]Jeffrey Stevens: relative reduction of cortisol compared to the other condition so conclusion typical and at risk students average level of cortisol per waking hour because that's kind of what we're looking at.
[01:03:06.210]are reduced or down regulated in response to a regular program frequent four week long program that combines H Ai with therapy dogs and stress management content now, I have some other really good findings, but I think i'm cut off right all right cool.
[01:03:24.360]Jeffrey Stevens: Listen, I apologize that I didn't get to what my abstract says, which would be more evidence for the model.
[01:03:33.540]Jeffrey Stevens: But it's always hard to time.
[01:03:36.090]Jeffrey Stevens: At 1am in the morning, so anyway, I appreciate this very much i'm excited about these findings and.
[01:03:44.940]Jeffrey Stevens: You know just just doing doing an interview, this was a three year study right, so we had four semesters of data collection three different groups.
[01:03:56.100]Jeffrey Stevens: per week day right, so you have Monday, you have a sm Tuesday of the combined 30 you know Thursday of the ha oh you do that for four semesters for 12 weeks.
[01:04:05.970]Jeffrey Stevens: takes forever to get these results and it's very it's over very quickly right it's like one little finding, but we have very good findings on.
[01:04:15.000]Jeffrey Stevens: A lot of these other outcomes as well, that really show interesting effects both physiological as well as even on academic related items, so if you're interested feel free to ask them.
[01:04:28.890]Thank you.
[01:04:36.750]Jeffrey Stevens: All right, come on up for questions.
[01:04:44.520]Jeffrey Stevens: Thank you for that wonderful talk I just had a question, it was quite striking to look at your your cartoon figure of the cortisol levels being.
[01:04:54.780]Jeffrey Stevens: Under circadian rhythm control So could you speak to any sort of.
[01:05:00.660]Jeffrey Stevens: interpretation as to whether we have to time these interventions to be most effective towards the target population, and particularly in terms of student populations were like most of these interventions happened during finals week where they have disrupted.
[01:05:22.230]Jeffrey Stevens: sleep wake cycles, you know pulling all nighters How would that affect the effectiveness of these guys yeah.
[01:05:29.670]Jeffrey Stevens: I think that's a that's a fabulous question one that keeps me up at night is now like How did we what do we do with all this information right to your first question, I think.
[01:05:40.320]Jeffrey Stevens: I feel very much that if, since we are able to demonstrate that fairly short term.
[01:05:48.180]Jeffrey Stevens: exposures can indeed at least momentarily reduce that what we think of is the reactive part of cortisol production during that day right it's the little blip that may be, we are brain down.
[01:06:01.290]Jeffrey Stevens: I think that that's the sort of your first inkling that there is something about that moment to moment interaction that can be relaxing however it may certainly be true that accomplishing that.
[01:06:17.130]may be easier to do even at times when students aren't in the midst of finals but we don't know that right we it could very well be that this is kind of.
[01:06:27.180]sort of the range of effects that we see and it's possible that people may be more reactive during a time of stress and more sensitive to.
[01:06:35.610]Experience down regulation because they're stressed right we don't know that there will be individual differences there and as well, for some people, as you can see from those early slides once you are stressed it's like you become this.
[01:06:50.190]You know it's it's possible that the down regulation that we saw here does have some individual differences when you look, you know if you repeat this study and look more broadly a different time periods.
[01:07:03.900]But it's possible that people who have risk may respond differently in a time that it's not finals right or that that that some of the moderation effects that are lurking in here right may come out more strongly.
[01:07:17.370]So I don't think we know the answer to that question in regards to sort of the more frequent exposures on a regular basis.
[01:07:24.930]I think of it very much within the prevention science paradigm and they're sort of the analogous medical model as well right you kind of decide who am I targeting.
[01:07:33.780]Is it universal Am I targeting particular individuals, am I selecting right there sort of primary tertiary.
[01:07:41.940]secondary and tertiary levels of intervention and that's where I think it comes in.
[01:07:46.710]When you think about individuals who potentially are already more stressed, so I can tell you, since gentlemen, let me show you those findings.
[01:07:55.740]That when we looked at executive function, for example, we see that there's a clear moderation affected by risk, so the folks who were more at risk, who are already experiencing stress related symptoms.
[01:08:10.140]For them, the only thing that really improved their executive function was a try to only heading right and that was that they were much more sensitive to that, if they were classified it as as as at risk.
[01:08:27.780]So, yet for some of the behavioral types of outcomes like study skills and study strategies which we also measured, it was the combination of padding.
[01:08:39.870]and receiving psycho educational content that was more effective for the high risk people why because there probably are some strategies beyond just.
[01:08:48.840]enjoying the down regulation that will play a role right, so I think the big picture here is that you know you have to think of it in terms of what is happening during the intervention.
[01:09:02.550]But also, what are the outcomes that you're measuring and for which individuals it's still a little unclear, we see less moderation.
[01:09:13.830]By stress related symptoms, either in day you're an old patterns or in momentary reactivity even though that's something that's been demonstrated in the stress literature.
[01:09:23.730]right we just and I think it's it's sort of a Type two error issue we don't have samples large enough to account for all the variations in dysregulation.
[01:09:33.120]That people who have stress related symptoms may experience but that's the million dollar question right that you're asking, so I am I think it's a great question and one that doesn't have an answer right this moment, thank you.
[01:09:53.550]Jeffrey Stevens: Good question so one Thank you so much for the talk, I really appreciate it, one thing I noticed, since you had this really like nice finding.
[01:10:03.120]Jeffrey Stevens: That, as your court decreases your family's increases, so my question for you is now, since you have some evidence that these systems are pretty well correlated.
[01:10:14.670]Jeffrey Stevens: Do you think going forward it's really helpful to collect both like thinking cost benefit analysis and, if so, which one, do you think would be more beneficial as well, so.
[01:10:27.240]Jeffrey Stevens: As you can the reason why I sort of show the picture of one of my graduate students with her stopwatch and sort of a concern to look on her face is that timing is extremely important for any kind of physiological sampling paradigm.
[01:10:44.520]As well as the the way in which and, at the moment in which you're doing that kind of sampling and I feel like in some way want to argue that maybe even more so for our families, because number one.
[01:10:57.540]The response time is different than that for cortisol right it's very quick they're sort of a two minute and and we don't have as much experience.
[01:11:10.290]In sampling alpha amylase I mean we we do we know what's going on, but the timing of that is potentially an issue when you want to.
[01:11:21.180]equate a particular exposure to either one of these analyzed and so that's one of the you know things that I kind of think is not.
[01:11:31.380]100% true to say it's a response because one is apparent after 25 minutes and another is already that response already started a few minutes in, so I think that's one thing you need to think about the other piece in terms of the data collection, for that is that you know.
[01:11:50.700]Jeffrey Stevens: You have to collect a lot of other samples for this, so if Jeff would only let me see show these.
[01:11:58.050]Jeffrey Stevens: test anxiety reactivity findings you'll find that, and this is very true for cortisol as well as for our families, you know if these data oftentimes are not normally distributed a lot goes into finding, what is the.
[01:12:11.130]Jeffrey Stevens: Correct transformation that you apply all of my work in these examples I showed you our ITT analysis, but sometimes you have to manually think about why you may not have a certain value for someone.
[01:12:27.840]Jeffrey Stevens: And there are controls that need to be put in place dependent on who these individual are so if you have a completely dis regulated slow.
[01:12:36.480]Jeffrey Stevens: right that may mean something different from one individual whether it's positive or negative, so you have to kind of consider that.
[01:12:43.320]Jeffrey Stevens: Otherwise we always keep having these Type two error issues where we find nothing which actually is very common in the.
[01:12:48.840]Jeffrey Stevens: literature, quite a few people have done in their leg up doesn't do anything well and it's because we didn't account for sort of the mess that can be involved with it, I personally would say.
[01:13:01.680]Jeffrey Stevens: For people who sort of start to explore this I think cortisol in many ways, gives you a little bit more, because we know more about what is associated to with regards to the development of psychopathology.
[01:13:16.770]Jeffrey Stevens: Rather than alpha amylase which again it captures arousal is it positive or negative, I mean it it's just less clear how it informs later outcomes as well, so if you have to make a choice do one or the other, and get more court samples and otherwise don't over interpret which.
[01:13:36.540]Right.
[01:13:41.340]Jeffrey Stevens: All right, thank you so much, please join me in thanking Professor pendry.
[01:13:50.910]Jeffrey Stevens: Okay, so that wraps up our time, for the moment we have.

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Conceptual and pathway models guiding research on identifying active treatment components of AAIs on stress-related outcomes

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